Discover the Benefits of Nutritional Therapy
Explore our comprehensive resources to support healthy diet and lifestyle changes in Crohn's disease and ulcerative colitis.
Nutrition is an Essential Part of Optimizing Care in IBD
Nutritional Therapy for IBD offers information about evidence-based nutritional options for patients with Crohn’s disease or ulcerative colitis. We understand the complexities of eating with IBD and maintaining a positive relationship with food when suffering from the symptoms of Inflammatory Bowel Disease. At times, it may feel like food is something to be feared or avoided. Learning more about evidence-based nutritional therapy under the guidance of your healthcare providers can help you find safe foods to restore a healthy relationship with food and work your way back to a well-balanced diet of healthy foods while at the same time feeling well again.
When nutritional strategies are used in combination with medications, additional pathways are engaged to improve symptoms, quality of life and aid tissue healing. Discover more of the benefits in "What is Nutritional Therapy" and in the boxes below.
The impact of dietary therapy on the microbiome
The term microbiome is used to collectively describe all of the microorganisms living in a specific environment or community. The gut microbiome encompasses the bacteria, viruses, and fungi, as well as their genes, that reside within the lining of the gastrointestinal tract.
The microbiome is becoming increasingly recognized for its importance in human health and disease and is one of the hottest topics in medicine right now, with IBD being the most extensively studied among disease states.1,2 Microbiome disturbances are commonly found in IBD and are increasingly implicated in the onset and development of IBD3,4 As diet has the greatest impact on the microbiome, it may offer the most manipulatable lever to modulate it for therapeutic benefit.5,6
Nutritional therapy offers the ability to affect the microbiome upstream at a potential source of inflammation, while medications target the immune system downstream. When using the therapies in combination, this two-pronged approach may offer a potential advantage for improved outcomes.7,8
How dietary therapy can improve mental health
Patients with IBD suffer disproportionally higher rates of depression and anxiety, which are associated with a lower quality of life9,10 and correlated with active disease.11 Furthermore, anxiety, depression, and fatigue, common comorbidities in IBD, are rated by patients to have the highest symptom severity scores in a recent international survey.12
The concept of the gut-brain axis has recently emerged, and it is increasingly accepted that the gut microbiota play an important role in communicating with our brain and regulating mood, including anxiety and depression.13 Disruptions in the gut microbiota, along with important interrelated dynamics of dysregulated stress and immunity, may be converging to influence the development of depression.14
Can diet impact the gut microbiota to influence the gut-brain axis and subsequently our mental health? Increasing data suggest that indeed it does, with diet playing a central role in our brain function, mood, and mental well-being.15 The recognized role of diet in shaping the gut microbiota is changing the available approaches that can be taken to improve a number of health conditions,16 including depression17 and anxiety,18 as pro-inflammatory diets are associated with poor mental health.19 Although more research is needed to fully evaluate the effects of nutrition on mental health, the emerging field of nutritional psychiatry is taking the lead in utilizing dietary interventions to improve mental health. Nutritional therapy may offer an attractive additional therapeutic option for IBD given the potential dual benefit of improving both the underlying condition of IBD and mental health.
References
Diet and the microbiome
- Lloyd-Price J, Arze C, Ananthakrishnan AN, et al. Multi-omics of the gut microbial ecosystem in inflammatory bowel diseases. Nature. 2019;569(7758):655-662. doi:10.1038/s41586-019-1237-9
- Integrative HMP (iHMP) Research Network Consortium. The Integrative Human Microbiome Project: dynamic analysis of microbiome-host omics profiles during periods of human health and disease. Cell Host Microbe. 2014;16(3):276-289. doi:10.1016/j.chom.2014.08.014
- Khan I, Ullah N, Zha L, et al. Alteration of Gut Microbiota in Inflammatory Bowel Disease (IBD): Cause or Consequence? IBD Treatment Targeting the Gut Microbiome. Pathogens. 2019;8(3):126. Published 2019 Aug 13. doi:10.3390/pathogens8030126
- Kostic AD, Xavier RJ, Gevers D. The microbiome in inflammatory bowel disease: current status and the future ahead. Gastroenterology. 2014;146(6):1489-1499. doi:10.1053/j.gastro.2014.02.009
- Sonnenburg ED, Sonnenburg JL. Starving our microbial self: the deleterious consequences of a diet deficient in microbiota-accessible carbohydrates. Cell Metab. 2014;20(5):779-786. doi:10.1016/j.cmet.2014.07.003
- Serban DE. Microbiota in Inflammatory Bowel Disease Pathogenesis and Therapy: Is It All About Diet?. Nutr Clin Pract. 2015;30(6):760-779. doi:10.1177/0884533615606898
- Green N, Miller T, Suskind D, Lee D. A Review of Dietary Therapy for IBD and a Vision for the Future. Nutrients. 2019;11(5):947. Published 2019 Apr 26. doi:10.3390/nu11050947
- Lee D, Albenberg L, Compher C, et al. Diet in the pathogenesis and treatment of inflammatory bowel diseases. Gastroenterology. 2015;148(6):1087-1106. doi:10.1053/j.gastro.2015.01.007
How dietary therapy can improve mental health - Bernstein CN. Addressing Mental Health in Persons with IBD. J Can Assoc Gastroenterol. 2018;1(3):97-98. doi:10.1093/jcag/gwy038
- Byrne G, Rosenfeld G, Leung Y, et al. Prevalence of Anxiety and Depression in Patients with Inflammatory Bowel Disease. Can J Gastroenterol Hepatol. 2017;2017:6496727. doi:10.1155/2017/6496727
- Marrie RA, Graff LA, Fisk JD, Patten SB, Bernstein CN. The Relationship Between Symptoms of Depression and Anxiety and Disease Activity in IBD Over Time. Inflamm Bowel Dis. 2021;27(8):1285-1293. doi:10.1093/ibd/izaa349
- Rubin DT, Sninsky C, Siegmund B, et al. International Perspectives on Management of Inflammatory Bowel Disease: Opinion Differences and Similarities Between Patients and Physicians From the IBD GAPPS Survey. Inflamm Bowel Dis. 2021;27(12):1942-1953. doi:10.1093/ibd/izab006
- Cryan JF, O'Riordan KJ, Cowan CSM, et al. The Microbiota-Gut-Brain Axis. Physiol Rev. 2019;99(4):1877-2013. doi:10.1152/physrev.00018.2018
- Cruz-Pereira JS, Rea K, Nolan YM, O'Leary OF, Dinan TG, Cryan JF. Depression's Unholy Trinity: Dysregulated Stress, Immunity, and the Microbiome. Annu Rev Psychol. 2020;71:49-78. doi:10.1146/annurev-psych-122216-011613
- Adan RAH, van der Beek EM, Buitelaar JK, et al. Nutritional psychiatry: Towards improving mental health by what you eat. Eur Neuropsychopharmacol. 2019;29(12):1321-1332. doi:10.1016/j.euroneuro.2019.10.011
- Hills RD Jr, Pontefract BA, Mishcon HR, Black CA, Sutton SC, Theberge CR. Gut Microbiome: Profound Implications for Diet and Disease. Nutrients. 2019;11(7):1613. Published 2019 Jul 16. doi:10.3390/nu11071613
- Duarte-Silva E, Clarke G, Dinan TG, Peixoto CA. Personalized Nutrition for Depression: Impact on the Unholy Trinity. Neuroimmunomodulation. 2021;28(2):47-51. doi:10.1159/000514094
- Norwitz NG, Naidoo U. Nutrition as Metabolic Treatment for Anxiety. Front Psychiatry. 2021 Feb 12;12:598119. doi: 10.3389/fpsyt.2021.598119. PMID: 33643090; PMCID: PMC7907178.
- Chen GQ, Peng CL, Lian Y, Wang BW, Chen PY and Wang GP (2021) Association Between Dietary Inflammatory Index and Mental Health: A Systematic Review and Dose–Response Meta-Analysis. Front. Nutr. 8:662357. doi: 10.3389/fnut.2021.66235
Lindsey Albenberg, DO
"Dietary approaches just make sense."
Maitreyi Raman, MD
"It is absolutely not your fault that you have been diagnosed with IBD" and "Diet is ready for prime time in IBD management."
Get Started
We promote a patient-centric approach for patients and clinicians to work together in shared decision-making to find the best dietary approach based on patients’ interests, resources, goals, and clinical considerations. "What is Nutritional Therapy” is a starting point to learn about evidence-based nutritional therapy for follow-up discussion with your physician and dietitian. Here the concept of nutritional therapy is introduced with an overview of the evidence-based dietary options that can be explored more thoroughly in the “dietary options“ section.
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Nutritional Therapy Guidelines
- Our resources are intended to complement the care provided by your medical team.
- The goal of nutritional therapy is to improve health, reach remission, and/or achieve higher levels of healing, not to be med-free.
- Resolution of symptoms is not always indicative of reduced inflammation or mucosal healing.
- A focus on food diversity and variety is essential for success.
- Always consult your medical team before modifying your therapy.
Delicious and Nutritious Recipes
Explore all recipesOur recipe section offers a wide range of options that align with various nutritional therapies, ensuring meals and snacks that are flavorful and supportive of dietary needs.
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The Latest in Lifestyle, Research and Resources
We regularly add new content to keep up with the latest research, provide you with the best additional resources, and give you valuable information, tips, and tricks to incorporate nutritional therapy into a healthy daily life.
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Stay Tuned!
Given the full array of options, it can be challenging for clinicians and patients to match the individuality of each patient and their disease presentation with the most appropriate dietary fit. Nutritional Therapy for IBD has developed a new patient-centric tool, including an algorithm, to help guide clinicians and patients in selecting a dietary approach.
Stay connected with us on social media and via our newsletter to be notified when this material is available.
Curious? Listen to the podcast of Gastro Broadcast with Dr. Ananthakrishnan, who is leading the development of this tool, and our founder Kim Beall.
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